PROMEDICA EAST PHYSICIANS, LLC (NPI# 1851436794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851436794 |
| Entity Type | Organization |
| Organization Name | PROMEDICA EAST PHYSICIANS, LLC |
| Other Organization Name | M. BASSAM ABAZA, M.D. AND WHADIA ABAZA, M.D. |
| Practice Address |
3156 Dustin Rd Suite 203 Oregon OH 43616-4342 |
| Practice Telephone | 4196981514 |
| Practice Fax Number | 4196983827 |
| Mailing Telephone | 4196981514 |
| Mailing Fax Number | 4196983827 |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | KIMBERLY GOVAN (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 4198247221 |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | ========= | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2278397 | 05 | |
| OH | AETNA | 5354423 | 01 |
| Other Name | Type Code |
|---|---|
| M. Bassam Abaza, M.D. and Whadia Abaza, M.D. | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982989513 | Promedica East Physicians, LLC | Family Medicine | 1215 Grassy Ln, Rossford, OH 43460-1525 | 2011-10-14 |
| 1760507305 | Promedica East Physicians, LLC | Anesthesiology | 2801 Bay Park Dr, Oregon, OH 43616-4920 | 2007-03-20 |
| 1386770352 | Promedica East Physicians, LLC | Obstetrics & Gynecology | 2751 Bay Park Dr, Suite 302, Oregon, OH 43616-4921 | 2007-02-26 |
| 1013043082 | Promedica East Physicians, LLC | Internal Medicine | 2751 Bay Park Dr, Suite 305, Oregon, OH 43616-4921 | 2007-02-26 |
| 1659407559 | Promedica East Physicians, LLC | Internal Medicine | 3156 Dustin Rd, Suite 300, Oregon, OH 43616-4342 | 2007-02-26 |
| 1336284991 | Promedica East Physicians, LLC | Family Medicine | 2751 Bay Park Dr, Suite 303, Oregon, OH 43616-4921 | 2007-02-21 |
| Street Address |
3156 DUSTIN RD SUITE 203 |
| City | OREGON |
| State | OH |
| Zip Code | 43616-4342 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184621963 | Mohamad Bassam Abaza | Pediatrics | 3156 Dustin Rd, Suite 203, Oregon, OH 43616-4342 | 2005-07-07 |
| 1184741266 | Fidencio T Alanis | Pediatrics | 3156 Dustin Rd, Suite 401, Oregon, OH 43616-4353 | 2007-03-23 |
| 1659407559 | Promedica East Physicians, LLC | Internal Medicine | 3156 Dustin Rd, Suite 300, Oregon, OH 43616-4342 | 2007-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699273086 | Tamara Dawson-kynard | Case Manager/Care Coordinator | 40 S Wheeling St, Oregon, OH 43616 | 2018-01-31 |
| 1053703728 | Robert Cousino | Technician | 3018 Springwood St. S, Oregon, OH 43616 | 2015-03-04 |
| 1023359502 | Enrich Medical Transoportation | Non-emergency Medical Transport (VAN) | 1041 Ansonia St, Oregon, OH 43616 | 2013-03-08 |
| 1265779284 | Kathleen C Pollauf | Massage Therapist | 2665 Navarre Ave, Suite A, Oregon, OH 43616 | 2013-01-10 |
| 1225318389 | Tanuja Shekhawat | Dentist | 3246 Navarre Ave., Oregon, OH 43616 | 2011-08-22 |
| 1932408622 | Lisa Marie Coughlin | Surgery | 2751 Bay Park Dr Ste 300-303, Oregon, OH 43616 | 2011-03-21 |
| 1356598940 | Ranvir Singh Rathore | Internal Medicine | 3841 Navarre Avenue, Oregon, OH 43616 | 2008-08-26 |
| 1114182276 | Jennifer Pfleghaar | Emergency Medicine | 2600 Navarre Avenue, Oregon, OH 43616 | 2008-07-28 |
| 1437318938 | Kelly C Mcgee | Nurse Practitioner | 3301 Navarne Avenue, Oregon, OH 43616 | 2008-06-09 |
| 1083712509 | Colony Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 2701 Navarre, Oregon, OH 43616 | 2006-09-20 |
| Find all providers in zip 43616 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306145156 | Katelyn Oostra | Pediatrics | 2751 Bay Park Dr Ste 303, Oregon, OH 43616-4922 | 2011-03-18 |
| 1184649956 | Kehinde Obeto | Pediatrics | 2702 Navarre Ave Ste 315, Oregon, OH 43616-3224 | 2006-07-13 |
| 1184621963 | Mohamad Bassam Abaza | Pediatrics | 3156 Dustin Rd, Suite 203, Oregon, OH 43616-4342 | 2005-07-07 |
| 1871948893 | Ashley Ann Muszynski | Pediatrics | 2751 Bay Park Dr Ste 303, Oregon, OH 43616-4922 | 2016-04-27 |
| 1184741266 | Fidencio T Alanis | Pediatrics | 3156 Dustin Rd, Suite 401, Oregon, OH 43616-4353 | 2007-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184237968 | Greater Cleveland Pediatrics | Pediatrics | 3311 Richmond Rd, Beachwood, OH 44122-4195 | 2020-08-31 |
| 1528677085 | Mariam Khan | Pediatrics | 2277 Summit St, Columbus, OH 43202-3131 | 2020-07-30 |
| 1447879200 | Amy C Buck | Pediatrics | 30 Kim Ct W, Westerville, OH 43081-2554 | 2020-04-13 |
| 1376170381 | Kathleen Sibyl Kress Farrell | Pediatrics | 14701 Detroit Ave Ste 250, Lakewood, OH 44107-4109 | 2020-03-27 |
| 1710526702 | Rebecca K Cibik | Pediatrics | 2497 State Route 59, Kent, OH 44240 | 2019-12-23 |
| 1992354344 | Rouba Sayegh | Pediatrics | 315 Frankfort Sq, Columbus, OH 43206-1061 | 2019-09-09 |
| 1972164556 | Grace Nikolai | Pediatrics | 9000 N Main St Ste 332, Englewood, OH 45415-1185 | 2019-06-25 |
| 1376012393 | Ohio North East Health Systems, Inc | Pediatrics | 2642 State Route 5, Cortland, OH 44410-9393 | 2018-11-20 |
| 1477022606 | Anthony George Pucell | Pediatrics | 1120 Gordon Rd, Lyndhurst, OH 44124-1335 | 2018-11-16 |
| 1861988875 | Sandeep Randhawa | Pediatrics | Rupert Health Centre, Utmc Campus, 3125, Transverse Drive, Toledo, OH 43614 | 2018-07-03 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.